# CAROLINA HEALTHCARE ASSOCIATES INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CAROLINA HEALTHCARE ASSOCIATES INC
- **Other names:** Wallace Urgent Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1356642342
- **Legal business name:** CAROLINA HEALTHCARE ASSOCIATES INC
- **Authorized official:** DANIEL GOODWIN (VICE-PRESIDENT)
- **Authorized official phone:** (910) 667-7597

## Contact information

- **Practice address:** 112 MEDICAL VILLAGE DR, STE G, WALLACE, NC 28466-1668
- **Practice address phone:** (910) 285-0333
- **Mailing address:** PO BOX 19305, CHARLOTTE, NC 28219-9305
- **Mailing address phone:** (704) 631-0002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 11/08/2010
- **Last updated:** 06/12/2020